Hyperparathyroidism

• Facts:
  80% due to single adenoma, 15% due to parathyroid hyperplasia
  
• History / PE:
  Stones ( nephrolithiasis )
  Bones (bone pain, fractures)
  Abdominal groans PUD, pancreatitis, N/V)
  Psychiatric overtones (fatigue, depression, sleep disturbances)
• Diagnosis:
  Hypercalcemia , hypercalciuria
  Hypophosphatemia
  Increased / inappropriately 'normal' PTH serum levels
• Complications:
  Osteitis fibrosis cystica
• Notes:
  Lithium and thiazides exacerbate hyperparathyroidism
• See Also:
  Albright hereditary osteodystrophy
  Secondary hyperparathyroidism
• Associated With:
  Hypercalcemia
  Multiple endocrine neoplasia
  Pseudogout
• Differential Diagnosis:
  Familial hypocalciuric hypercalcemia (decreased urinary calcium excretion)